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Abstract：
Gastric Cancer epidemics have changed over recent decades, declining in incidence, shifting from distal to proximal location, transforming from intestinal to diffuse histology. Novel chemotherapeutic agents combined with modern surgical operations hardly changed overall disease related survival. This may be attributed to a substantial inherent geographical variation of disease genetics, but also to a failure to standardize and implement treatment protocols in clinical practice. To overcome these drawbacks in Greece and Cyprus, a Gastric Cancer Study Group under the auspices of the Hellenic Society of Medical Oncology (HeSMO) and Gastrointestinal Cancer Study Group (GIC-SG) merged their efforts to produce a consensus considering ethnic parameters of healthcare system and the international proposals as well. Utilizing structured meetings of experts, a consensus was reached. To achieve further consensus, statements were subjected to the Delphi methodology by invited multidisciplinary national and international experts. Sentences were considered of high or low consensus if they were voted by ≥ 80%, or < 80%, respectively; those obtaining a low consensus level after both voting rounds were rejected. Forty-five statements were developed and voted by 71 experts. The median rate of abstention per statement was 9.9% (range: 0-53.5%). At the end of the process, one statement was rejected, another revised, and all the remaining achieved a high consensus. Forty-four recommendations covering all aspects of the management of gastric cancer and concise treatment algorithms are proposed by the Hellenic and Cypriot Gastric Cancer Study Group. The importance of centralization, care by a multidisciplinary team, adherence to guidelines, and individualization are emphasized.
摘要：
近几十年来，胃癌的流行发生了变化，发病率下降，从远端位置转移到近端位置，从肠组织学转变为弥漫性组织学。新型化学治疗剂与现代外科手术相结合几乎不会改变与疾病相关的总体生存率。这可能归因于疾病遗传学的巨大固有地理差异，但也未能在临床实践中规范和实施治疗方案。为了克服希腊和塞浦路斯的这些缺点，在希腊医学肿瘤学会（HeSMO）和胃肠道肿瘤研究小组（GIC-SG）的主持下，胃癌研究小组合并了他们的努力，以达成共识，考虑到医疗保健系统的种族参数和国际建议。利用专家的结构化会议，达成了共识。进一步达成共识,受邀的多学科国家和国际专家对陈述进行了Delphi方法论。如果判决以≥80%的投票结果被认为是高或低共识，或<80%，分别；在两轮投票后获得较低共识的人被拒绝。71名专家制定并投票通过了45项声明。每次陈述的弃权率中位数为9.9％（范围：0-53.5％）。过程结束时,一个声明被拒绝了,另一个修订,其余各方达成了高度共识。希腊和塞浦路斯胃癌研究小组提出了涵盖胃癌管理各个方面的44项建议和简洁的治疗算法。中央集权的重要性，由一个多学科的团队照顾，遵守准则，强调个性化。
